-
Epidemiology and Risk Factor of the Gallstone Disease in a Southern Tropical Country
Solonirina Davidà Rakotomena,
Sedera Arimino,
Finaritra Casimir Fleur Prudence Rahantasoa,
Antso Hasina Raherinandrasana,
Tianarivelo Rajaonarivony,
Hery Nirina Rakoto Ratsimba
Issue:
Volume 5, Issue 6, December 2019
Pages:
73-78
Received:
12 November 2019
Accepted:
4 December 2019
Published:
13 December 2019
Abstract: Despite the tendency to westernize our way of life, the Malagasy culture keeps its peculiarities. We report the epidemiological features of patients with cholelithiasis in our population in order to raise hypothesis about their risk factors. This is a retrospective descriptive multicenter and analytical case-control study of patients with cholelithiasis as "cases" and non-carriers of cholelithiasis as "controls". The odds ratios (ORs) were calculated with a 95% confidence interval to verify the correlation between food consumption and the occurrence of cholelithiasis. 51 patients were respectively enrolled for both groups. Consumption of animal products and legumes, such as offal (OR 95% CI 3.23-1.36-7.67), chicken (OR 95% CI 8.85 [3.02-25.9]), peas (OR 95% CI 1.13 [0.43 - 2.95]) and Bambara peas (OR 95% CI 1.31 [0.57 - 3.01 ]) would expose the risk of occurrence of cholelithiasis. In contrast, whole milk (OR 95% CI 1.27 [0.58 - 2.77]), sweet potato (OR 95% CI 0.72 [0.23 - 2.25]) and cassava (OR 95% CI 0.83 [0.36 - 1.92]) would be a protective factor. To conclude, the diversification of our fruits and vegetables could be an asset to reduce the frequency of occurrence of cholelithiasis, giving priority to their consumption.
Abstract: Despite the tendency to westernize our way of life, the Malagasy culture keeps its peculiarities. We report the epidemiological features of patients with cholelithiasis in our population in order to raise hypothesis about their risk factors. This is a retrospective descriptive multicenter and analytical case-control study of patients with cholelith...
Show More
-
Critical Determinants of Supply of Services in the Nigeria Formal Sector Social Health Insurance Programme
Obi Ikechukwu Vincent,
Okoronkwo Ijeoma Lewechi,
Adi Jesse Ashumate
Issue:
Volume 5, Issue 6, December 2019
Pages:
79-84
Received:
21 November 2019
Accepted:
13 December 2019
Published:
24 December 2019
Abstract: Introduction: The principle underpinning the Supply of health insurance services in Nigeria is that as prices increases, the healthcare provider makes more profit and will be motivated to provide more health insurance services to the enrollees. These supplies of health insurance services are therefore influenced by critical determinants that will either make the provider to supply health insurance services or withhold it. Therefore, there is a need to look at those critical factors that can hinder the supply of services in the programme. This study sets out to examine the effect of identified critical determinants on supply of services and also show how much these critical determinants can collectively predict this supply of services. Design/Methodology: This is a cross sectional study using a quantitative approach. Sample size was determined using Cochran formular and calculated sample size was forty six (46). Multistage sampling technique was adopted. Variables were analyzed using descriptive statistics and linear regression method with SPSS version 11. Result: The critical determinants of reimbursement structure, tariff structure, facility number of enrollees and cost of hospital consumables studied had positive impact on the supply of service but the impact of cost of hospital consumable was insignificant (>0.5). Similarly, 95% of changes in the supply of services can be accounted for significantly by the independent variables in this study (p=0.000). Conclusion: Evidences from this study have shown that most of the identified critical determinants studied had significant effect and also collectively could account significantly for changes in the supply of services and so therefore there is a need to properly address these factors so as to achieve the set out objectives in the programme.
Abstract: Introduction: The principle underpinning the Supply of health insurance services in Nigeria is that as prices increases, the healthcare provider makes more profit and will be motivated to provide more health insurance services to the enrollees. These supplies of health insurance services are therefore influenced by critical determinants that will e...
Show More
-
A New Observation of Volvulus of the Gallbladder
Rahantasoa Finaritra Casimir Fleur Prudence,
Rakotomena Solonirina Davida,
Kalouche Ibrahim,
Rakoto Ratsimba Hery Nirina
Issue:
Volume 5, Issue 6, December 2019
Pages:
85-88
Received:
20 November 2019
Accepted:
18 December 2019
Published:
25 December 2019
Abstract: Background: The volvulus of the gallbladder is a rotation of the gallbladder around its cystic pedicle. It is a relatively rare disease in the literature. Only 400 cases have been described. The diagnostic may be difficult in preoperative. The aim of our study is to report an observation of gallbladder volvulus to discuss its diagnostic and therapeutic management in relation to the literature. Observation: A 63-year-old woman was admitted for febrile hepatic colic. The biological examination revealed an hyperleukocytosis at 12000G/L, ASAT was at three times normal and ALAT at four times normal. Total bilirubin and conjugated bilirubin were without particularity. The most likely diagnosis was an acute cholecystitis in front of the clinical status, leading to ultrasound of the liver and bile ducts. The scanographic explorations had suspected a torsion of gallbladder. The diagnosis of gallbladder volvulus was made intraoperatively during exploratory laparotomy. The gallbladder was gangrened, twisted in a turn of the clockwise. The cholecystectomy was made after detorsion. The evolution was favorable. Conclusion: The volvulus of the gallbladder is a rare cause of acute cholecystitis. The medical imaging is a key element for the diagnostic. The prognosis is good in front of an early diagnosis. The cholecystectomy is the only surgery treatment.
Abstract: Background: The volvulus of the gallbladder is a rotation of the gallbladder around its cystic pedicle. It is a relatively rare disease in the literature. Only 400 cases have been described. The diagnostic may be difficult in preoperative. The aim of our study is to report an observation of gallbladder volvulus to discuss its diagnostic and therape...
Show More
-
Diagnosis and Management’s Distinctive Features of an Ectopic Spleen in a Precarious Country
Solonirina Davidà Rakotomen,
Narindra Njarasoa Mihaja Razafimanjato,
Kanto Adrienne Razafindraibe,
Auberlin Felantsoa Rakototiana,
Hery Nirina Rakoto-Ratsimba
Issue:
Volume 5, Issue 6, December 2019
Pages:
89-91
Received:
19 November 2019
Accepted:
9 December 2019
Published:
30 December 2019
Abstract: Abdominal or pelvic ectopic spleen or wandering spleen or drifting spleen is extremely rare. It is a consequence of congenital or acquired laxity of this organ’s attachment to the diaphragmatic dome, especially the suspensor ligament. The authors report a new typical case of this pathology in a 27-year-old woman, having came to consultation for painfull pelvic mass in the Joseph Ravoahangy Andrianavalona University Hospital Center in Antananarivo Madagascar, which is a precarious country. The positive diagnostic of this pathology and its surgical approach are often limited by the locally available tools and the financial accessibility of the patient to them. Ultrasonography and Computed Tomography imaging show the emptiness of the splenic lodge, localize the spleen with its size, and precise its vascularisation’s pathway. The symptoms are naturally latent until complication appears. Surgery is more formally indicated in case of complication or because of the risk of confusion with parasitic splenomegaly which has a high prevalence in a tropical country as Madagascar. Splenopexy can exposes to more recurrences, systemacic splenectomy can expose to risks of more postoperative infection even it is more practiced. As proposed in the literature, laparoscopy could and should be developed because it does not have any eventful recovery.
Abstract: Abdominal or pelvic ectopic spleen or wandering spleen or drifting spleen is extremely rare. It is a consequence of congenital or acquired laxity of this organ’s attachment to the diaphragmatic dome, especially the suspensor ligament. The authors report a new typical case of this pathology in a 27-year-old woman, having came to consultation for pai...
Show More
